Skip to main content
Top
Published in: World Journal of Surgery 9/2016

01-09-2016 | Original Scientific Report

Multifocal Versus Solitary Papillary Thyroid Carcinoma

Authors: Andreas Kiriakopoulos, Athanassios Petralias, Dimitrios Linos

Published in: World Journal of Surgery | Issue 9/2016

Login to get access

Abstract

Background

Papillary Thyroid Carcinoma (PTC) which accounts for >85 % of all thyroid cancers in iodine-rich areas, appears either as a single tumor or as two or more, neoplastic foci within the thyroid gland (Multifocal PTC). We present the comparative results between solitary and MFC PTC.

Materials and methods

Demographics, tumor characteristics (size, laterality, foci number, histologic subtype) and TNM staging were compared between solitary and MFPTC patients. The presence of lymphocytic or Hashimoto’s thyroditis was also recorded.

Results

From January 2008 to December 2012, among 647 PTC patients, 241(37.2 %) had MFPTC 177 females (73.4 %) and 64 males (26.6 %), mean age 48.5 years (range 12–87). Mean number of tumor foci was 3.3 (range 2–26). MFPTC patients presented with more advanced T stage (28.2 vs. 18.7 %, p = 0.01) and more LN metastases (28.6 vs. 15.5 %, p < 0.001). Foci number correlates with male gender and LN metastases (p = 0.014 and p = 0.019, respectively). Central (N1a) or lateral (N1b) LN involvement correlates strongly with male gender (p  = 0.024) and younger age (p < 0.001). The follicular variant was the next most frequent histologic subtype associated with extremely rare LN metastases.

Conclusion

MFPTC comprises a more aggressive form of papillary thyroid cancer since it is associated with more frequent N1a/ N1b disease and occurs more frequently in T3/T4 patients. MFPTC foci number correlates with male gender and LN metastases.
Literature
1.
go back to reference Davies L, Morris Luc GT, Haymart M et al (2015) American Association of Clinical Endocrinologists and American College of Endocrinology disease state clinical review: the increasing incidence of thyroid cancer. Endocr Pract 21:686–696CrossRefPubMedPubMedCentral Davies L, Morris Luc GT, Haymart M et al (2015) American Association of Clinical Endocrinologists and American College of Endocrinology disease state clinical review: the increasing incidence of thyroid cancer. Endocr Pract 21:686–696CrossRefPubMedPubMedCentral
2.
go back to reference Kim HJ, Sohn SY, Jang HW et al (2013) Multifocality, but not bilaterality, is a predictor of disease recurrence/persistence of papillary thyroid carcinoma. World J Surg 37:376–384CrossRefPubMed Kim HJ, Sohn SY, Jang HW et al (2013) Multifocality, but not bilaterality, is a predictor of disease recurrence/persistence of papillary thyroid carcinoma. World J Surg 37:376–384CrossRefPubMed
3.
go back to reference Lin JD, Chao TC, Hsueh C et al (2009) High recurrent rate of multicentric papillary thyroid carcinoma. Ann Surg Oncol 16:2609–2616CrossRefPubMed Lin JD, Chao TC, Hsueh C et al (2009) High recurrent rate of multicentric papillary thyroid carcinoma. Ann Surg Oncol 16:2609–2616CrossRefPubMed
4.
go back to reference Hay ID, Hutchinson ME, Gonzalez-Losada T et al (2008) Papillary thyroid microcarcinoma: a study of 900 cases observed in a 60-year period. Surgery 144:980–988CrossRefPubMed Hay ID, Hutchinson ME, Gonzalez-Losada T et al (2008) Papillary thyroid microcarcinoma: a study of 900 cases observed in a 60-year period. Surgery 144:980–988CrossRefPubMed
5.
go back to reference Zhao Q, Ming J, Liu C et al (2013) Multifocality and total tumor diameter predict central neck lymph node metastases in papillary thyroid microcarcinoma. Ann Surg Oncol 20:746–752CrossRefPubMed Zhao Q, Ming J, Liu C et al (2013) Multifocality and total tumor diameter predict central neck lymph node metastases in papillary thyroid microcarcinoma. Ann Surg Oncol 20:746–752CrossRefPubMed
6.
go back to reference So YK, Son YI, Hong SD et al (2010) Subclinical lymph node metastasis in papillary thyroid microcarcinoma: a study of 551 resections. Surgery 148:526–531CrossRefPubMed So YK, Son YI, Hong SD et al (2010) Subclinical lymph node metastasis in papillary thyroid microcarcinoma: a study of 551 resections. Surgery 148:526–531CrossRefPubMed
7.
go back to reference Ito Y, Miyauchi A (2008) Lateral lymph node dissection guided by preoperative and intraoperative findings in differentiated thyroid carcinoma. World J Surg 32:729–739CrossRefPubMed Ito Y, Miyauchi A (2008) Lateral lymph node dissection guided by preoperative and intraoperative findings in differentiated thyroid carcinoma. World J Surg 32:729–739CrossRefPubMed
8.
go back to reference Iacobone M, Jansson S, Barczyński M, Goretzki P (2014) Multifocal papillary thyroid carcinoma—a consensus report of the European Society of Endocrine Surgeons (ESES). Langenbecks Arch Surg 399:141–154CrossRefPubMed Iacobone M, Jansson S, Barczyński M, Goretzki P (2014) Multifocal papillary thyroid carcinoma—a consensus report of the European Society of Endocrine Surgeons (ESES). Langenbecks Arch Surg 399:141–154CrossRefPubMed
9.
go back to reference Fridman MV, Savva NN, Krasko OV et al (2012) Clinical and pathologic features of “sporadic” papillary thyroid carcinoma registered in the years 2005 to 2008 in children and adolescents of Belarus. Thyroid 22:1016–1024CrossRefPubMed Fridman MV, Savva NN, Krasko OV et al (2012) Clinical and pathologic features of “sporadic” papillary thyroid carcinoma registered in the years 2005 to 2008 in children and adolescents of Belarus. Thyroid 22:1016–1024CrossRefPubMed
10.
go back to reference Bogdanova TI, Zurnadzhy LY, Greenebaum E et al (2006) A cohort study of thyroid cancer and other thyroid diseases after the Chernobyl accident. Cancer 107:2559–2566CrossRefPubMedPubMedCentral Bogdanova TI, Zurnadzhy LY, Greenebaum E et al (2006) A cohort study of thyroid cancer and other thyroid diseases after the Chernobyl accident. Cancer 107:2559–2566CrossRefPubMedPubMedCentral
11.
go back to reference Jovanovic L, Delahunt B, McIver B et al (2008) Most multifocal papillary thyroid carcinomas acquire genetic and morphotype diversity through subclonal evolution following the intraglandular spread of the initial neoplastic clone. J Pathol 215:145–154CrossRefPubMed Jovanovic L, Delahunt B, McIver B et al (2008) Most multifocal papillary thyroid carcinomas acquire genetic and morphotype diversity through subclonal evolution following the intraglandular spread of the initial neoplastic clone. J Pathol 215:145–154CrossRefPubMed
12.
go back to reference Sugg SL, Ezzat S, Rosen IB et al (1998) Distinct multiple RET/PTC gene rearrangements in multifocal papillary thyroid neoplasia. J Clin Endocrinol Metab 83:4116–4122PubMed Sugg SL, Ezzat S, Rosen IB et al (1998) Distinct multiple RET/PTC gene rearrangements in multifocal papillary thyroid neoplasia. J Clin Endocrinol Metab 83:4116–4122PubMed
13.
go back to reference Moniz S, Catarino AL, Marques AR et al (2002) Clonal origin of nonmedullary thyroid tumors assessed by nonrandom X chromosome inactivation. Eur J Endocrinol 146:27–33CrossRefPubMed Moniz S, Catarino AL, Marques AR et al (2002) Clonal origin of nonmedullary thyroid tumors assessed by nonrandom X chromosome inactivation. Eur J Endocrinol 146:27–33CrossRefPubMed
14.
go back to reference Park SY, Park YJ, Lee YJ et al (2006) Analysis of differential BRAFV600E mutational status in multifocal papillary thyroid carcinoma: evidence of independent clonal origin in distinct tumor foci. Cancer 107:1831–1838CrossRefPubMed Park SY, Park YJ, Lee YJ et al (2006) Analysis of differential BRAFV600E mutational status in multifocal papillary thyroid carcinoma: evidence of independent clonal origin in distinct tumor foci. Cancer 107:1831–1838CrossRefPubMed
15.
go back to reference Lin X, Finkelstein SD, Zhu B et al (2008) Molecular analysis of multifocal papillary thyroid carcinoma. J Mol Endocrinol 41:195–203CrossRefPubMed Lin X, Finkelstein SD, Zhu B et al (2008) Molecular analysis of multifocal papillary thyroid carcinoma. J Mol Endocrinol 41:195–203CrossRefPubMed
16.
go back to reference Lundgren CI, Hall P, Dickman PW et al (2006) Clinically significant prognostic factors for differentiated thyroid carcinoma: a population-based, nested case–control study. Cancer 106:524–531CrossRefPubMed Lundgren CI, Hall P, Dickman PW et al (2006) Clinically significant prognostic factors for differentiated thyroid carcinoma: a population-based, nested case–control study. Cancer 106:524–531CrossRefPubMed
Metadata
Title
Multifocal Versus Solitary Papillary Thyroid Carcinoma
Authors
Andreas Kiriakopoulos
Athanassios Petralias
Dimitrios Linos
Publication date
01-09-2016
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 9/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-016-3628-5

Other articles of this Issue 9/2016

World Journal of Surgery 9/2016 Go to the issue